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Lupus
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Acute renal failure complicating HELLP syndrome, SLE and anti-phospholipid syndrome: successful outcome using plasma exchange therapy

G Roberts

Department of Rheumatology, Gartnavel General Hospital, Glasgow, UK, sggcmay{at}aol.com

M M Gordon

Department of Rheumatology, Gartnavel General Hospital, Glasgow, UK

D Porter

Department of Rheumatology, Gartnavel General Hospital, Glasgow, UK

A G Jardine

Renal Unit and Medicine and Therapeutics, Western Infirmary, Glasgow, UK

I W Gibson

Department of Pathology, Western Infirmary, Glasgow, UK

Renal disease is very common in patientswith systemic lupus erythematosis(SLE) and it may emerge during pregnancy or the post-partumperiod. Patients with anti-phospholipidsyndrome (APS) are also at risk of renal disease.We present a case of acute renal failure in the post-partumperiod in a patient with SLE and APS. This case illustrates the potential difficulties in reaching a diagnosis in such a patient. It also illustrates the complexities of management and the potential interactionsbetween SLE, Haemolysis, elevated liver enzymes and low platelets syndrome, thrombotic thrombocytopenic purpura, haemolytic uraemic syndrome and APS. We also review the role of plasma exchange therapy in managing our patient.

Key Words: systemic lupus erythematosis • anti-phospholipid syndrome • HELLP syndrome (haemolysis, elevated liver enzymes and low platelets) • TTP (thrombotic thrombocytopenicpurpura) • plasma exchange

Lupus, Vol. 12, No. 4, 251-257 (2003)
DOI: 10.1191/0961203303lu378xx
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